Risk for Complications after Pacemaker or Cardioverter Defibrillator Implantations in Patients with Myotonic Dystrophy Type 1

Article type: Research Article

Authors: Sochala, Maximilien^{a; 1} | Wahbi, Karim^{a; b; 1; *} | Sorbets, Emmanuel^c | Lazarus, Arnaud^d | Bécane, Henri-Marc^b | Stojkovic, Tanya^b | Fayssoil, Abdallah^b | Laforêt, Pascal^{b; e} | Béhin, Anthony^b | Sroussi, Marjorie^a | Eymard, Bruno^{b; e} | Duboc, Denis^{a; b} | Meune, Christophe^c

Affiliations: [a] Department of Cardiology, AP-HP, Cochin Hospital, Paris Descartes University, Paris, France | [b] AP-HP, Pitié-Salpêtrière Hospital, Myology Institute, Paris, France | [c] Department of Cardiology, AP-HP, Avicenne Hospital, Bobigny, France; Paris XIII University, Bobigny, France | [d] InParys Clinical Research Associates, Saint Cloud, Paris, France | [e] Pierre and Marie Curie University, Paris, France

Correspondence: [*] Correspondence to: Karim Wahbi, MD, PhD, Department of Cardiology, Cochin Hospital, 27 rue du Faubourg Saint Jacques, 75679 PARIS Cedex 14, France. Tel.: +33 1 58 41 16 53; Fax: +33 1 58 41 16 66; E-mail: karim.wahbi@aphp.fr.

Note: [1] These two authors contributed equally to this work.

Abstract: Background:Pacemakers (PM) and implantable cardioverter defibrillators (ICD) may be indicated for sudden death prevention in myotonic dystrophy type 1 (DM1), however the risk of complications after the placement of these devices is unknown. Objective:To compare the rate of device-related complications between PM and ICD implantations in patients with DM1. Methods:Among 914 patients with DM1 included in the DM1 Heart Registry between January 2000 and January 2010, we retrospectively selected 23 patients who were implanted with an ICD and matched them to 46 controls with a PM on age, gender, and year of device placement. Results:Over a 6 years follow-up period, we observed device-related complications in 9 ICD recipients (inappropriate shocks in 5, lead dysfunction in 5, infection in 2) and in 3 PM recipients (lead dysfunction in 3). Patients with an ICD had, compared to those with a PM, higher rates of complications (39.1% vs. 6.5%, p = 0.0006) and more frequent complications requiring hospitalisation and/or re-intervention (respectively 30.4% and 21.7% vs. 0%). Conclusion:Our study shows a higher risk of device-related complications after the implantation of an ICD than for a PM in patients presenting with DM1.

Keywords: Myotonic dystrophy 1, complications, implantable cardioverter-defibrillator, pacemaker

DOI: 10.3233/JND-170232

Journal: Journal of Neuromuscular Diseases, vol. 4, no. 3, pp. 175-181, 2017